momwhoneedsanap

Keto Diet and Bariatric Patients?

8 posts in this topic

Has anyone decided to start a Keto diet post-sleeve?  I'm 5 months post-sleeve and just starting a Keto diet.  I knew I was in trouble when I felt so bad after the sleeve.  Testing confirmed my fears, I was allergic to almost everything I was eating on the bariatric diet.  Lactose, carrageenan, soy, even whey.  All that's left for protein is egg whites and plant based.

I've found almost NOTHING in the literature about the Keto diet in Bariatric patients.  We simply CAN NOT consume enough calories to meet standard intake levels for Keto.  However, I feel 20 years younger on the diet - fewer joint aches, no hunger, mental clarity, even energy.  Only 4 days - what a difference!  I haven't seen the scale move yet, but my pants are starting to droop.   

For those of you who are unfamiliar with Keto, it's macros are a bit different than bariatric macros.  Much higher fat, medium protein, super low carbs.  I can have as much full fat whipped cream as I want, but not an apple.  It's such a backward seeming diet - but it works.  Hit a stall? 3-4 days on eggs only (keep up the hydration, of course).  Eggs any way you want them.  Swimming in butter or an omelet or fried in olive oil or baked in a quiche.  Interesting.

So - is anyone here on a keto diet post-sleeve?  What kind of calorie intake and macros do you use?  Are you losing faster than non-keto bariatric patients?  Does it all seem so much easier than adjusting to the bariatric diet?  Please let me know...

 

CoTN likes this

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I am not familiar with the Keto diet, but based on your description, it sounds similar to the original Atkins Diet during the induction period where the objective is to limit carbs to 25 grams a day and reach a state of ketosis. It even had you testing your urine daily with special strips to determine if you had reached ketosis!!

I don't think that bariatric surgery requires any special type of diet, per se, as long as it allows you to lose weight and maintain general nutrition, protein and liquid requirements. The two most common bases of diets, bariatric or otherwise, are probably either calories or carbohydrates, and both have generally been proven to be effective for losing weight and keeping it off. I personally prefer a low carb diet, primarily because I have always found it doesn't sacrifice taste as much as a low calorie based diet does. Plus, if you are Type 2 diabetic, as I was before my surgery, low carbs can be even more beneficial in reducing your blood sugar. Probably the most effective diet is both low carb and low calorie, but I think it would also require low taste making it very hard to maintain, at least for me!! They cut away 75% of my stomach, but I think it would have been even more effective if they had cut away 75% of my taste buds!!!

Since about a month after my surgery, I have generally followed a low carb diet, generally less than 50 grams a day. There are a lot more low carb items available now if you do a little research on the web, so it is a lot easier to follow a low carb diet now than it was 20-30 years ago.

It sounds like the Keto diet is working for you, but I am not sure that 4 days is long enough yet to declare it a success!!

You indicate that the Keto diet may be considered somewhat backward, but I think it would only be considered backward because of the low fat mantra that our government has been trying to sell for the last 20-30 years with very little scientific basis!! And the result has been unprecedented obesity in our population!!

Pam G likes this

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I have not done keto post-op yet as I'm only on week 3, but I intend to start weaning into it once I'm back on regular foods and have tested what my stomach can handle. I don't think necessarily that post-op wls means you can't successfully use a keto-diet, but I would be careful adding in your fats. It may not be as much as an issue with a VSG versus a RYN since a VSG does not remove any intestinal track for nutrient absorption, but high fats still have the chance to trigger dumping syndrome. And that's very very not good.

I think for blending a keto and bariatric diet successfully, still focus on getting your 2-3 oz of protein at each meal if possible and complement it with a healthy fat like the eggs cooked in butter, or meat with avocado. Since you have allergies to many of the common protein sources, definitely talk to a nutritionist to go over what type of foods you'll be eating and that might want to include still sipping on a protein shake throughout the day with some MCT oil added in there to load your macros. You can even use MCT oil while cooking and it'll give you a good boost.

Calorie wise, I think you'll be aiming for 800-1,000 easy a day with the fats and might need to watch that you're not going too high. Macros (fats, protein, carbs), might see if you can balance it to keep your fats and your proteins pretty even at 50-40-10, or 45-35-20.

Let me know how it goes!

P.S. Not sure if you have tried it, but I have been lactose intolerant since a kid and I found Fair-Life milk a couple of years ago that I am able to drink without issues. Due to their filtering process, it removes practically all lactose from the milk and has 13g of protein per 8 ounces so it's a good amount for the fat and carb ratios.

CoTN likes this

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I've done the Keto way of eating.  I'll be one yr post sleeve this Friday!  woo hoo!

People keep saying that we don't need to "diet" after WLS, but I disagree 100%.  If I went back to the old ways, I'd blow up so faaaast!

so, Yeah, I'm on a frikken diet for the rest of my life.....or else.

But back to keto.....it's a good way for us to eat. You get plenty of protein (maybe too much at times). You really do need to use some sort of tracking app, though, cause those carbs are lurking everywhere....even in your little packet of Splenda!

It's so hard to stay under 20 gms of carbs, but totallly doable.  I did it at first, failed for a month or two, kept trying, then finally got there.  Lost weight.  Then started upping the carbs.  Wt loss slowed, but still happening.  I keep telling myself to get back under at least 30 gms of carbs/day, but it's really tough.

oh, and if you add intermittant fasting into the mix, it's even better.  (only eat 8 hours out of the day, like from 11am to 7pm, and fast the rest of the time)

 

 

Edited by Pam G
cinwa likes this

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On 5/2/2017 at 7:41 PM, Jerry M said:

They cut away 75% of my stomach, but I think it would have been even more effective if they had cut away 75% of my taste buds!!!

 

Ain't THAT the truth! LOL

momwhoneedsanap likes this

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At my center, the recommendation is to keep carbohydrates < 50 g per day after surgery, which gets many (not all) people into ketosis. My guess is that a lot of people are (intentionally or unintentionally) in ketosis after WLS. If I go to the Library of Medicine site (PubMed) @momwhoneedsanap is right, there really isn't much on this topic. (Am hoping for you that your allergies are intolerances and that in the future your diet can broaden out!). @Pam G There are studies showing that for the same caloric intake, you lose on ketogenic diets and don't with a regular (more carbs) diet. I can't imagine this isn't true for those of us after WLS too. 

The data on beneficial oils and fats - like those found in the typical Mediterranean diet, nuts and olive oil and fish - is compelling. In some studies of people at risk - those with prior heart attacks and such - death rates were really reduced in trials with interventions that included as much as two tablespoons of olive oil a day. Those studies didn't try to promote weight loss, they were head-to-head studies of taking beneficial oils or not. 

So I'm focusing on protein and the beneficial oils. Even this approach has to be careful... older studies showed high protein diets stressed kidney function. I don't know if the beneficial oils will lower the risk of gall stones... http://www.thinnertimes.com/weight-loss-surgery/gastric-bypass/gallbladder.html

 

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Although I don't follow a keto diet strictly, I don't eat any starchy foods other than the occasional scant 1/4 cup of beans (although I eat fish/shellfish, I don't eat meat or eggs so the protein in beans is welcome.

I don't worry about fats - butter rules in this house!

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n.b. This was fun!

There is suggestive medical information that olive oil decreases the chance of gallstones too, but I haven't seen a trial.

There are a lot of sites on the web claiming that olive oil (sometimes really big amounts, not on a WLS diet!) can help dissolve stones. Just for fun, here is an 1895 article with one person suggesting it might help. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2509801/

On the other hand, this was a topic debunked on Quackwatch: https://www.quackwatch.org/01QuackeryRelatedTopics/flushes.html

Like Cinwa, I cook with butter too! just had sous-vide swordfish seared in butter last night. Not much in the way of carbos there. :rolleyes:

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